Temporal triangular alopecia, also referred as congenital triangular alopecia, is an uncommon dermatosis of unknown etiology. It is characterized by a non-scarring, circumscribed alopecia often located unilaterally in the frontotemporal region. It usually emerges at ages 2-9 years. Alopecia areata is the main differential diagnosis, especially in atypical cases. Dermoscopy is a noninvasive procedure that helps distinguish temporal triangular alopecia from aloepecia areata. Such procedure prevents invasive diagnostic methods as well as ineffective treatments.
The pretibial myxedema is a manifestation of Graves' disease characterized by accumulation of glycosaminoglycans in the reticular dermis. The dermopathy is self-limiting but in some cases may cause cosmetic and functional damage. Conventional treatment is use of topical steroids under occlusive dressing, however the intralesional application has shown good results. We present a case of pretibial myxedema treated with single injection of intralesional corticosteroid.
Coinfections with human immunodeficiency virus (HIV) and infectious agents have been recognized since the early 90s. In the central nervous system (CNS) of HIV+ patients, parasitic protozoans like Toxoplasma gondii have been described as responsible for the space occupying lesions (SOL) developed. However, the involvement of Trypanosoma cruzi is also described but appears to be less frequent in acquired immunodeficiency syndrome (AIDS) and transplant recipients, associated with necrotizing myocarditis and neurological symptoms related to the occurrence of necrotizing pseudotumoral encephalitis (NPE) and meningoencephalitis (NME). The present work aims to present a Venezuelan case of NME associated with the coinfection of HIV and a T. cruzi-like trypanosomatid as well as its evolution and diagnosis by histopathological techniques, electron microscopy, and PCR methods using formalin-fixed- (FF-) and paraffin-embedded- (PE-) tissues. Postmortem cytological studies of leptomeninges imprints reveal the presence of trypomastigotes of Trypanosoma sp. Histopathological and electron microscopy studies allowed us to identify an amastigote stage and to reject the involvement of other opportunistic microorganisms as the etiological agent of the SOL. The definitive confirmation of T. cruzi as the etiological agent was achieved by PCR suggesting that the NME by T. cruzi was due to a reactivation of Chagas' disease.
Exogenous ochronosis consists of chronic hyperpigmentation of areas previously treated with topical agents such as hydroquinone, resorcinol, antimalarials and phenol. Early diagnosis allows to promptly suspend the causative agent and it is imperative since the available therapeutic options are scarce and have presented so far unsatisfactory results. Three cases of exogenous ochronosis on the face which were diagnosed with the use of dermoscopy are presented. Dermatoscopy showed blackish-gray amorphous structures, some obliterating the follicular openings. Histopathological examination confirmed the diagnosis. Keywords: Dermoscopy; Ochronosis; Pigmentation disorders Resumo: A ocronose exógena consiste em hiperpigmentação crônica de áreas previamente tratadas com agentes tópicos como: a hidroquinona, a resorcina, os antimaláricos e o fenol. O diagnóstico precoce permite suspender prontamente o agente causador, uma vez que as opções terapêuticas disponíveis são escassas e com resultados insatisfatórios. Reportam-se três casos de ocronose exógena na face, diagnosticados pela dermatoscopia. O estudo dermatoscópico evidenciou estruturas amorfas de coloração cinza-enegrecido, algumas obliterando as aberturas foliculares. O exame histopatológico corroborou o diagnóstico.
RESUMO -Lobomicose ou doença de Jorge Lobo é uma infecção crónica e granulomatosa causada pela implantação traumática do fungo Lacazia loboi. Esta doença acomete pele e tecido celular subcutâneo. Trata-se de uma dermatose infecciosa típica de regiões tropicais e subtropicais que acomete frequentemente homens adultos ativos nas áreas florestais, além de ter sido diagnosticada em golfinhos. No geral afecta áreas expostas da pele, tais como o pavilhão auricular, os membros superiores e inferiores. Lesões queiloidiformes constituem a manifestação clínica mais comum. A remoção cirúrgica é o procedimento terapêutico de escolha nos casos iniciais, enquanto itraconazol e clofazimina, isolados ou em associação, podem ser utilizados nos casos disseminados. PALAVRAS-CHAVE -Brasil; Dermatomicoses; Lacazia; Lobomicose; Pele. Lobomycosis ABSTRACT -Lobomycosis or Jorge Lobo's disease is a chronic granulomatous infection, caused by the traumatic implantation of the fungus Lacazia loboi, that affects the skin and subcutis. This dermatosis is typical of tropical and subtropical regions and affects mainly active adult males working in the forest INTRODUÇÃOLobomicose, mais recentemente apelidada de Lacaziose, é uma infecção fúngica causada pela levedura Lacazia loboi, previamente chamada Loboa loboi. Esta dermatose, típica das áreas tropicais e sub-tropicais, acomete principalmente a pele exposta, poupando as mucosas. As lesões queloidiformes são a apresentação clínica mais comum. Em termos histológicos, observa-se reação inflamatória granulomatosa crônica que predomina na derme. 1,2Relatos limitados de casos demonstraram que a lobomicose apresenta distribuição em áreas endêmicas na América Latina, tendo uma incidência maior na Amazónia brasileira.2 Na realidade aqui ocorrem a maioria dos diagnósticos, 1,2 mas recentemente foram relatados 15 casos na Índia.3 Um novo cenário epidemiológico está vinculado em algumas espécies de golfinhos. 4,5 CASO CLÍNICO Doente do sexo masculino, 58 anos, de raça negra, agricultor, proveniente de Iranduba, município da região
Hemangioma is the most common tumor of childhood and is commonly located on the head or neck. The orbit is often affected and early and aggressive intervention is required to prevent serious visual complications. This paper reports on two cases. In the first case, the patient's vision was impaired, while in the second case a deep hemangioma affecting adjacent areas was confirmed radiologically. Treatment with aggressive systemic corticotherapy was successful, thus avoiding permanent damage to the patients' vision. Furthermore, esthetic outcome was satisfactory. The treatment of choice is oral corticosteroids and management should be individualized and should include careful follow-up to monitor possible adverse effects. Keywords: Adrenal cortex hormones; Glucocorticoids; Hemangioma; Hemangioma, capillary; Hemangioma, cavernous; therapeutics Resumo: Hemangioma é o tumor mais comum da infância, frequentemente situado na cabeça e pescoço. A órbi-ta é frequentemente acometida e indica intervenção precoce e agressiva para evitar sérias complicações visuais. Reportam-se dois casos, nos quais há impedimento da visão no primeiro e, no segundo, um hemangioma profundo acomete áreas adjacentes, confirmado por exame radiológico. Demonstra-se sucesso terapêutico após corticoterapia sistêmica agressiva, evitando sequelas visuais permanentes, além do resultado estético satisfatório. O tratamento de escolha é o corticosteroide oral, devendo ser conduta individualizada e com bom seguimento clí-nico dos possíveis efeitos adversos.
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